Accuracy of the Screening Tool for Autism in Toddlers and Young Children in the primary care setting / Rebecca MCNALLY KEEHN in Autism, 29-4 (April 2025)  

Public ISBD [article]  inAutism > 29-4 (April 2025) . - p.945-957 Titre : Accuracy of the Screening Tool for Autism in Toddlers and Young Children in the primary care setting Type de document : Texte imprimé et/ou numérique Auteurs : Rebecca MCNALLY KEEHN, Auteur ; Noha F. MINSHAWI, Auteur ; Qing TANG, Auteur ; Brett ENNEKING, Auteur ; Tybytha RYAN, Auteur ; Ann Marie MARTIN, Auteur ; Angela PAXTON, Auteur ; Patrick O. MONAHAN, Auteur ; Mary CICCARELLI, Auteur ; Brandon KEEHN, Auteur Article en page(s) : p.945-957 Langues : Anglais (eng) Mots-clés : autism  diagnosis  primary care Index. décimale : PER Périodiques Résumé : Feasible and accurate assessment tools developed for non-specialists are needed to scale community-based models of autism evaluation. The purpose of this study was to evaluate use of the Screening Tool for Autism in Toddlers and Young Children (STAT) when used by primary care practitioners (n = 10) across a statewide system of early diagnosis set within seven United States primary care practices. Specifically, for 130, 14- to 48-month-old children, we examined (1) agreement between STAT classification and Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) outcome and expert diagnosis of autism, (2) characteristics of children with inaccurate STAT classifications, (3) consistency between STAT classification and primary care practitioner diagnosis, and (4) the relationship between STAT/primary care practitioner classification and expert diagnosis. The STAT demonstrated good concurrent validity with the ADOS-2 (77% agreement). Concordance between specialty trained primary care practitioners with expert diagnosis was 80%-87% across three age-based subgroups of children. Children misclassified by the STAT were older, had higher developmental and adaptive skills, and lower autism symptoms. Primary care practitioner diagnosis aligned with STAT categorical risk classification in 86% of cases, and 73% of consistent classifications between STAT and primary care practitioner diagnosis matched expert diagnosis. Overall, the STAT demonstrates good accuracy when used by non-specialists as part of a diagnostic evaluation.Lay summary Specialists conduct autism evaluations using tools that are expensive and difficult to get trained on. Families often wait a long time and travel far to get a diagnosis for their child. To help with this problem, primary care practitioners can be trained to provide evaluations in local communities. However, usable and accurate tools developed for non-specialists are needed. The Screening Tool for Autism in Toddlers and Young Children (STAT) was created for this purpose, but limited research has been done on accuracy of the tool in community primary care. This study tested the STAT when used by primary care practitioners as part of a diagnostic evaluation in 130, 14- to 48-month-old children. We tested (1) STAT agreement with the Autism Diagnostic Observation Schedule, Second Edition (ADOS-2), and diagnosis based on an expert research evaluation, and (2) the relationship between STAT classification, primary care practitioner diagnosis, and expert diagnosis. STAT classification matched the ADOS-2 in 77% of cases and expert diagnosis in 78% of cases. Autistic children incorrectly classified by the STAT were older, had higher developmental and adaptive skills, and fewer autism symptoms. In 86% of cases, the STAT classification agreed with primary care practitioner diagnosis. STAT classification, primary care practitioner diagnosis, and expert diagnosis agreed in 73% of cases. Overall, the STAT shows good accuracy when used by primary care practitioners as part of a community primary care autism evaluation. En ligne : https://dx.doi.org/10.1177/13623613241292850 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=552 [article] Accuracy of the Screening Tool for Autism in Toddlers and Young Children in the primary care setting [Texte imprimé et/ou numérique] / Rebecca MCNALLY KEEHN, Auteur ; Noha F. MINSHAWI, Auteur ; Qing TANG, Auteur ; Brett ENNEKING, Auteur ; Tybytha RYAN, Auteur ; Ann Marie MARTIN, Auteur ; Angela PAXTON, Auteur ; Patrick O. MONAHAN, Auteur ; Mary CICCARELLI, Auteur ; Brandon KEEHN, Auteur . - p.945-957. Langues : Anglais (eng) in Autism > 29-4 (April 2025) . - p.945-957 Mots-clés : autism  diagnosis  primary care Index. décimale : PER Périodiques Résumé : Feasible and accurate assessment tools developed for non-specialists are needed to scale community-based models of autism evaluation. The purpose of this study was to evaluate use of the Screening Tool for Autism in Toddlers and Young Children (STAT) when used by primary care practitioners (n = 10) across a statewide system of early diagnosis set within seven United States primary care practices. Specifically, for 130, 14- to 48-month-old children, we examined (1) agreement between STAT classification and Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) outcome and expert diagnosis of autism, (2) characteristics of children with inaccurate STAT classifications, (3) consistency between STAT classification and primary care practitioner diagnosis, and (4) the relationship between STAT/primary care practitioner classification and expert diagnosis. The STAT demonstrated good concurrent validity with the ADOS-2 (77% agreement). Concordance between specialty trained primary care practitioners with expert diagnosis was 80%-87% across three age-based subgroups of children. Children misclassified by the STAT were older, had higher developmental and adaptive skills, and lower autism symptoms. Primary care practitioner diagnosis aligned with STAT categorical risk classification in 86% of cases, and 73% of consistent classifications between STAT and primary care practitioner diagnosis matched expert diagnosis. Overall, the STAT demonstrates good accuracy when used by non-specialists as part of a diagnostic evaluation.Lay summary Specialists conduct autism evaluations using tools that are expensive and difficult to get trained on. Families often wait a long time and travel far to get a diagnosis for their child. To help with this problem, primary care practitioners can be trained to provide evaluations in local communities. However, usable and accurate tools developed for non-specialists are needed. The Screening Tool for Autism in Toddlers and Young Children (STAT) was created for this purpose, but limited research has been done on accuracy of the tool in community primary care. This study tested the STAT when used by primary care practitioners as part of a diagnostic evaluation in 130, 14- to 48-month-old children. We tested (1) STAT agreement with the Autism Diagnostic Observation Schedule, Second Edition (ADOS-2), and diagnosis based on an expert research evaluation, and (2) the relationship between STAT classification, primary care practitioner diagnosis, and expert diagnosis. STAT classification matched the ADOS-2 in 77% of cases and expert diagnosis in 78% of cases. Autistic children incorrectly classified by the STAT were older, had higher developmental and adaptive skills, and fewer autism symptoms. In 86% of cases, the STAT classification agreed with primary care practitioner diagnosis. STAT classification, primary care practitioner diagnosis, and expert diagnosis agreed in 73% of cases. Overall, the STAT shows good accuracy when used by primary care practitioners as part of a community primary care autism evaluation. En ligne : https://dx.doi.org/10.1177/13623613241292850 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=552

Tele-assessment of young children referred for autism spectrum disorder evaluation during COVID-19: Associations among clinical characteristics and diagnostic outcome / Rebecca MCNALLY KEEHN in Autism, 27-5 (July 2023)  

Public ISBD [article]  inAutism > 27-5 (July 2023) . - p.1362-1376 Titre : Tele-assessment of young children referred for autism spectrum disorder evaluation during COVID-19: Associations among clinical characteristics and diagnostic outcome Type de document : Texte imprimé et/ou numérique Auteurs : Rebecca MCNALLY KEEHN, Auteur ; Brett ENNEKING, Auteur ; Tybytha RYAN, Auteur ; Cristina JAMES, Auteur ; Qing TANG, Auteur ; Audra BLEWITT, Auteur ; Angela TOMLIN, Auteur ; Laura CORONA, Auteur ; Liliana WAGNER, Auteur Article en page(s) : p.1362-1376 Langues : Anglais (eng) Mots-clés : autism spectrum disorders;diagnosis;health services;tele-assessment Index. décimale : PER Périodiques Résumé : Since the onset of the COVID-19 pandemic, there has been a rapid acceleration of innovative research on health services delivery, including real-world clinical implementation and evaluation of tele-assessment for the diagnosis of autism spectrum disorder. Extending this promising work, the present study examined clinical characteristics and diagnostic outcome for young children receiving autism spectrum disorder tele-assessment during the COVID-19 pandemic. The standard tele-assessment procedure included caregiver clinical interview, administration of the TELE-ASD-PEDS (TAP; a novel caregiver-mediated remote autism spectrum disorder observational assessment tool), Vineland-3, and diagnostic feedback and family counseling. Overall, our findings suggest that a definitive autism spectrum disorder diagnosis can be determined for most young children evaluated using standard tele-assessment procedures. While TAP scores and measures of adaptive functioning and Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition autism spectrum disorder symptoms are highly associated with autism spectrum disorder diagnostic outcome, a specific pattern of Restricted and Repetitive Behaviors independently predicted differential autism spectrum disorder outcome. Furthermore, our findings suggest that the TAP is useful for evaluation of at-risk children above 36?months of age with delayed language. These results add to an increasing body of research supporting use of tele-assessment, and specifically the TAP, for diagnosis of young children referred for autism spectrum disorder evaluation. Lay abstract The diagnosis of autism spectrum disorder (ASD) has traditionally been made through in-person evaluation. While the COVID-19 pandemic disrupted access to ASD services, there has been remarkable growth in research focused on novel ASD diagnostic practices, including the use of telemedicine. We implemented a standard ASD tele-assessment evaluation procedure, including use of a novel remote clinician-coached, caregiver-delivered ASD assessment tool (TELE-ASD-PEDS; TAP), with the goal of continuing to provide diagnostic services to young children and their families during the pandemic. We examined the relationship between child characteristics and diagnostic outcome for 335 children, ages 14-78?months, who received ASD tele-assessment conducted by psychologists and pediatricians in an outpatient clinic of a Midwestern academic medical center. We found that clinicians could make a determination about ASD diagnosis for most children (85%) evaluated using tele-assessment. Child clinical characteristics, including TAP scores and clinician ratings of ASD symptoms, were related to diagnostic outcome (i.e. diagnosis of ASD, no ASD, and Unsure about ASD). When all clinical characteristics were examined together, the presence of specific repetitive behaviors predicted ASD diagnosis. We also found that the TAP is effective for making an ASD diagnosis when used as part of comprehensive tele-assessment evaluation in children???36?months of age with delayed language. Our study adds to an increasing body of research supporting use of tele-assessment for diagnosis of ASD. Although further research is needed, telemedicine may help families from different backgrounds and geographic locations to access high-quality diagnostic services. En ligne : http://dx.doi.org/10.1177/13623613221138642 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=507 [article] Tele-assessment of young children referred for autism spectrum disorder evaluation during COVID-19: Associations among clinical characteristics and diagnostic outcome [Texte imprimé et/ou numérique] / Rebecca MCNALLY KEEHN, Auteur ; Brett ENNEKING, Auteur ; Tybytha RYAN, Auteur ; Cristina JAMES, Auteur ; Qing TANG, Auteur ; Audra BLEWITT, Auteur ; Angela TOMLIN, Auteur ; Laura CORONA, Auteur ; Liliana WAGNER, Auteur . - p.1362-1376. Langues : Anglais (eng) in Autism > 27-5 (July 2023) . - p.1362-1376 Mots-clés : autism spectrum disorders;diagnosis;health services;tele-assessment Index. décimale : PER Périodiques Résumé : Since the onset of the COVID-19 pandemic, there has been a rapid acceleration of innovative research on health services delivery, including real-world clinical implementation and evaluation of tele-assessment for the diagnosis of autism spectrum disorder. Extending this promising work, the present study examined clinical characteristics and diagnostic outcome for young children receiving autism spectrum disorder tele-assessment during the COVID-19 pandemic. The standard tele-assessment procedure included caregiver clinical interview, administration of the TELE-ASD-PEDS (TAP; a novel caregiver-mediated remote autism spectrum disorder observational assessment tool), Vineland-3, and diagnostic feedback and family counseling. Overall, our findings suggest that a definitive autism spectrum disorder diagnosis can be determined for most young children evaluated using standard tele-assessment procedures. While TAP scores and measures of adaptive functioning and Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition autism spectrum disorder symptoms are highly associated with autism spectrum disorder diagnostic outcome, a specific pattern of Restricted and Repetitive Behaviors independently predicted differential autism spectrum disorder outcome. Furthermore, our findings suggest that the TAP is useful for evaluation of at-risk children above 36?months of age with delayed language. These results add to an increasing body of research supporting use of tele-assessment, and specifically the TAP, for diagnosis of young children referred for autism spectrum disorder evaluation. Lay abstract The diagnosis of autism spectrum disorder (ASD) has traditionally been made through in-person evaluation. While the COVID-19 pandemic disrupted access to ASD services, there has been remarkable growth in research focused on novel ASD diagnostic practices, including the use of telemedicine. We implemented a standard ASD tele-assessment evaluation procedure, including use of a novel remote clinician-coached, caregiver-delivered ASD assessment tool (TELE-ASD-PEDS; TAP), with the goal of continuing to provide diagnostic services to young children and their families during the pandemic. We examined the relationship between child characteristics and diagnostic outcome for 335 children, ages 14-78?months, who received ASD tele-assessment conducted by psychologists and pediatricians in an outpatient clinic of a Midwestern academic medical center. We found that clinicians could make a determination about ASD diagnosis for most children (85%) evaluated using tele-assessment. Child clinical characteristics, including TAP scores and clinician ratings of ASD symptoms, were related to diagnostic outcome (i.e. diagnosis of ASD, no ASD, and Unsure about ASD). When all clinical characteristics were examined together, the presence of specific repetitive behaviors predicted ASD diagnosis. We also found that the TAP is effective for making an ASD diagnosis when used as part of comprehensive tele-assessment evaluation in children???36?months of age with delayed language. Our study adds to an increasing body of research supporting use of tele-assessment for diagnosis of ASD. Although further research is needed, telemedicine may help families from different backgrounds and geographic locations to access high-quality diagnostic services. En ligne : http://dx.doi.org/10.1177/13623613221138642 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=507

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